Infection may cause stillbirth by several mechanisms, including directinfection, placental damage, and severe maternal illness. Various organisms havebeen associated with stillbirth, including many bacteria, viruses, and protozoa.

In developed countries, between 10% and 25% of stillbirths may be caused by an infection, whereas in developing countries, which have much higher stillbirthrates, the contribution of infection is much greater. In developed countries,ascending bacterial infection, both before and after membrane rupture, withorganisms such as Escherichia coli, group B streptococci, and Ureaplasmaurealyticum is usually the most common infectious cause of stillbirth. However,in areas where syphilis is prevalent, up to half of all stillbirths may becaused by this infection alone. Malaria may be an important cause of stillbirthin women infected for the first time in pregnancy. The two most important viralcauses of stillbirth are parvovirus and Coxsackie virus, although a number ofother viral infections appear to be causal. Toxoplasma gondii, Listeriamonocytogenes, and the organisms that cause leptospirosis, Q fever, and Lymedisease have all been implicated as etiologic for stillbirth. In certaindeveloping countries, the stillbirth rate is high and the infection-relatedcomponent so great that achieving a substantial reduction in stillbirth shouldbe possible by reducing maternal infections. However, because infection-relatedstillbirth is uncommon in developed countries, and because those that do occurare caused by a wide variety of organisms, reducing this etiologic component ofstillbirth much further will be difficult. PMID: 19285457 [PubMed - as supplied by publisher]

Received 10 April 2009; received in revised form 29 May 2009; accepted 23 July 2009. published online 19 November 2009.

Summary

Background

There is disagreement regarding whether Lyme borreliosis is associated with adverse pregnancy outcome.

Methods

We performed a review of the data from 95 women with Lyme borreliosis during pregnancy, evaluated at the Center for Tick-borne Diseases, Budapest over the past 22 years.
Results

Treatment was administered parenterally to 66 (69.5%) women and orally to 19 (20%). Infection remained untreated in 10 (10.5%) pregnancies. Adverse outcomes were seen in 8/66 (12.1%) parentally treated women, 6/19 (31.6%) orally treated women, and 6/10 (60%) untreated women. In comparison to patients treated with antibiotics, untreated women had a significantly higher risk of adverse pregnancy outcome (odds ratio (OR) 7.61, p=0.004). While mothers treated orally had an increased chance (OR 3.35) of having an adverse outcome compared to those treated parenterally, this difference was not statistically significant (p=0.052). Erythema migrans did not resolve by the end of the first antibiotic course in 17 patients. Adverse pregnancy outcome was more frequent among these ?slow responder? mothers (OR 2.69), but this was not statistically significant (p=0.1425) . Loss of the pregnancy (n=7) and cavernous hemangioma (n=4) were the most prevalent adverse outcomes in our series. The other complications were heterogeneous.

Conclusion

Our results indicate that an untreated maternal Borrelia burgdorferi s.l. infection may be associated with an adverse outcome, although bacterial invasion of the fetus cannot be proven. It appears that a specific syndrome representing ?congenital Lyme borreliosis? is unlikely.

April 28, 2010, 5:30 pm
Julie Antenucci of Endicott has suffered for years from the effects of a single tick bite incurred in her Maryland backyard. Her unborn third child was infected with three of the five tick-borne maladies she continues to battle. (VALERIE ZEHL / Staff Photo)

Eight months pregnant with her third child, Julie Antenucci glanced in the mirror while getting ready for an appointment with her obstetrician. She brushed away a black dot on her belly -- but it didn't move. To her horror, she realized it was a tick deeply embedded near her navel.

She developed the tell-tale bull's-eye at the site. Three weeks of antibiotics was prescribed, a quantity she would later learn was woefully inadequate for the five diseases the tick had transmitted to her: borreliosis (Lyme disease), bartonellosis, babesiosis ("malaria of the Northeast"), anaplasmosis and mycoplasmosis.
Her newborn, infected with three of those diseases in utero, was put on intravenous, then oral, antibiotics and suffered no further ill effects.

But for Julie, that tick bite in 2003 precipitated years of deteriorating health and skyrocketing medical expenses as she and husband Ugo, who lived in Maryland at the time, tried to convince their insurance company and doctors she was suffering from the tick-borne maladies -- while those professionals tried to convince the Antenuccis that Julie was faking her symptoms or had a psychiatric disorder.

"I have been laughed at, shrugged at, ridiculed and kicked out of hospitals and medical offices," Julie explains. "I will never trust an institution that follows ISDA (Infectious Diseases Society of America) Lyme disease guidelines again."

Some symptoms mimicked those of multiple sclerosis and arthritis, another had her going rigid and able to hear but unable to speak or react.

By the time symptoms were finally controlled only months ago by a doctor following International Lyme and Associated Diseases Society (ILADS) guidelines, she and Ugo had spent about $100,000 out of pocket.

Now the Antenuccis, who live in Endicott, are experts on the subject of tick-borne illnesses -- and want to use their hard-won knowledge to caution everyone they can. "Lyme disease is at the same point AIDS was in the 1980s," Ugo says. "It's marginalized. Doctors poo-pooed it."

They say many doctors are uninformed about appropriate treatment and are unable even to correlate symptoms to their real cause. Insurance companies also don't understand the longstanding crippling effect the diseases can have, so they routinely reject payment for extended treatment. The few physicians who specialize in tick-borne diseases generally don't deal with insurance companies anyhow, but have long waiting lists.

And few people realize how dangerous a tick bite can be, the Antenuccis continue. Now 43, Julie will never be able to work again and must take a handful of pills daily to keep her symptoms in check -- all traceable to that one virulent tick.

In order to qualify for disability through Social Security, she needed a psychiatrist to attest that it wasn't all in her head.

"Ms. Antenucci has no psychiatric disorder," the report states. "She believes, and I would agree with her, that the diagnosis of ... depression was primarily financially based as an attempt by the insurance company not to pay for medical treatment for her Lyme disease."

Vindication in being granted disabled status was gratifying, she says, but nowhere near enough compensation for her years of physical suffering and the anguish inflicted by medical professionals who refused to believe her.

The mystery of autism may never be solved, but research is giving doctors new hope in trying to put the puzzle pieces together. Doctors are starting to find links between children with autism and other diseases that may play a role. One of those links now has a name, it?s called ?Lyme Induced Autism?.

19-year-old Mary Hendricks was diagnosed with severe autism and developmental delay before she was 2 years old.

"She had a little bit of language and lost it. A little bit of eye contact and lost it," said Mary?s mom, Tina Hendricks.

But there was something more going on with Mary that was going undiagnosed, and it stayed that way for 17 years.

"She was having these developmental issues, but she was also sick," continued Tina.

Mary was sick with digestive problems, skin infections and internal problems that caused Mary to be in pain for a large majority of every day. The Hendricks took Mary to doctor after doctor in hopes of finding one that could pinpoint the problem, but each doctors visit seemed to be only a quick fix for the immediate issue.

"If she was awake she was moaning, crying out in pain, biting herself, chewing on herself, banging herself in the head," said Mary?s dad, Danny Hendricks.

That cycle continued for 17 years, until the Hendricks were sent to an Autism Specialist who had a whole new take on Mary and the issues that had taken over her life. That specialist asked Tina about her own health history.

Tina told the doctor that for years she had battled her own health issues; including colitis, fibromyalgia and symptoms that seemed like a never ending bout with the flu.

"He said the key to diagnosing Mary, is diagnosing you," Tina told FOX40.

The specialist ordered a Lyme Disease test for Tina and it came back positive and a few days later, Mary also tested positive for Lyme. Tina says before she got pregnant with Mary, she found two ticks on her skin. She removed them and never really thought much about the possibility of Lyme.

"If a child has autism from birth, many times it's because the child inherited an infection from the mother. I do think that Lyme disease, especially congenital Lyme is a cause of autism ," said Autism Specialist Dr. Lynn Mielke.

Dr. Miekle says Mary contracted Lyme disease from Tina through pregnancy and she believes the Lyme played a big role in the development of Mary?s autism. Immediately, Mielke started a full assault on Mary?s Lyme symptoms and in a matter of weeks the success was beyond their expectations.

"As we treat Mary for her Lyme, some of her check list autism symptoms are disappearing," said Tina.

"For her to wake up, smile and giggle and laugh .. we haven't heard that for years," added Danny.

Miekle told FOX40 the severity of Mary?s autism may prevent her from having improvement beyond minimal, but for the Hendricks even small improvements translate to be huge miracles.

"I have had patients in my practice with autism who when we treated their Lyme disease, their autism improved so much that they were no longer autistic,? said Mielke.